Factors influencing psychosocial adjustment in hemodialysis patients

Abstract

Purpose: The purpose of this study was to identify the factors involved in psychosocial adjustment of hemodialysis patients. Methods: This correlational, cross-sectional study included 172 hemodialysis patients from 11 different nephrology clinics. Data was collected from May to August 2018 using a structured questionnaire including patient' characteristics, uncertainty, social support, coping, and psychosocial adjustment. Data was analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression. Results: The total score for psychosocial adjustment was 406.23±44.58 out of a maximum of 700. Psychosocial adjustment had a statistically significant relationship with occupation(t=-3.88, p < .001) and albumin (t=-2.06, p=.041). Furthermore, uncertainty (r=.45, p < .001), social support (r=-.37, p < .001), and coping (r=-.31, p < .001) were significantly correlated with psychosocial adjustment. Stepwise multiple linear regression demonstrated that uncertainty, having an occupation, social support, and being women explained 35.4% of the variance in psychosocial adjustment. Conclusion: Uncertainty was found to have the largest influence on psychosocial adjustment, followed by occupation, social support, and gender. It is necessary to develop a detailed intervention that considers all these factors to promote psychosocial adjustment of patients with hemodialysis. Furthermore, the importance of the psychosocial adjustment of chronic illness needs to be stressed in nursing education.